1. More subtle microsatellite instability better predicts fluorouracil insensitivity in colorectal cancer patients
- Author
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Kaname Miyashita, Seijiro Shioi, Tatsuhiro Kajitani, Yumiko Koi, Mototsugu Shimokawa, Akitaka Makiyama, Shinya Oda, and Taito Esaki
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Microsatellite instability (MSI) ,DNA mismatch repair (MMR) ,Drug resistance ,5-fluorouracil (5-FU) ,Fluoropyrimidine ,Colorectal cancer ,Medicine ,Science - Abstract
Abstract Microsatellite instability (MSI) is now widely used as an indispensable biomarker. However, the relationship between MSI-H (high) and defective DNA mismatch repair (MMR) is not as straightforward as has been expected. Genome-edited cells carrying Lynch syndrome mutations do not exhibit drastic MSI typical in MSI-H (i.e. Type B) but more subtle MSI (i.e. Type A). In this study, we explored a connection between Type A MSI and 5-fluorouracil (5-FU) resistance in colorectal cancer patients. Using our precision and high-resolution MSI assay technique, tumour microsatellites were analysed in 30 colorectal cancer patients treated with FOLFOX or CAPOX. Among 30 tumours, eleven (37%) were judged as Type A MSI-positive. In Type A MSI+ tumours, the patient response to fluoropyrimidine and oxaliplatin was significantly poor (Fisher’s exact test, p = 0.021). Accordingly, median PFS and OS were significantly poor in Type A+ patients (log-rank test, p
- Published
- 2024
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